Credentialing Internal Medicine Physicians to Expand Long-Acting Reversible Contraceptive Access
Authors: Jennifer L. Michener, David A. Hirsh, Pelin Batur, Rachel S. Casas, Vidya Gopinath, Lydia E. Pace, Christine Prifti, Jennifer Rusiecki, Eleanor Bimla Schwarz, Megha Shankar, Mindy Sobota, Deborah Gomez Kwolek
Journal: Annals of Internal Medicine (2023)

Ideas and OpinionsAugust 2023Credentialing Internal Medicine Physicians to Expand Long-Acting Reversible Contraceptive AccessJennifer L. Michener, MD*, David A. Hirsh, MD*, Pelin Batur, MD, Rachel S. Casas, MD, EdM, Vidya Gopinath, MD, Lydia E. Pace, MD, MPH, Christine Prifti, MD, Jennifer Rusiecki, MD, Eleanor Bimla Schwarz, MD, MS, Megha Shankar, MD, Mindy Sobota, MD, MS, MPhil, and Deborah Gomez Kwolek, MDJennifer L. Michener, MD*University of Colorado, Anschutz Medical Campus, Aurora, Colorado (J.L.M.)Search for more papers by this author, David A. Hirsh, MD*Harvard Medical School, Boston, Massachusetts, and Cambridge Health Alliance, Cambridge, Massachusetts (D.A.H.)Search for more papers by this author, Pelin Batur, MDCleveland Clinic Lerner College of Medicine, Cleveland, Ohio (P.B.)Search for more papers by this author, Rachel S. Casas, MD, EdMPenn State College of Medicine, Hershey, Pennsylvania (R.S.C., M.S.)Search for more papers by this author, Vidya Gopinath, MDWarren Alpert Medical School of Brown University, Providence, Rhode Island (V.G., M.S.)Search for more papers by this author, Lydia E. Pace, MD, MPHHarvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts (L.E.P.)Search for more papers by this author, Christine Prifti, MDBoston University School of Medicine, Boston, Massachusetts (C.P.)Search for more papers by this author, Jennifer Rusiecki, MDThe University of Chicago Pritzker School of Medicine, Chicago, Illinois (J.R.)Search for more papers by this author, Eleanor Bimla Schwarz, MD, MSSan Francisco General Hospital, University of California, San Francisco, California (E.B.S.)Search for more papers by this author, Megha Shankar, MDPenn State College of Medicine, Hershey, Pennsylvania (R.S.C., M.S.)Search for more papers by this author, Mindy Sobota, MD, MS, MPhilWarren Alpert Medical School of Brown University, Providence, Rhode Island (V.G., M.S.)Search for more papers by this author, and Deborah Gomez Kwolek, MDHarvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (D.G.K.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1034 Annals Author Insight Video - Jennifer L. Michener, MD In this video, Jennifer L. Michener, MD, offers additional insight into the article, "Credentialing Internal Medicine Physicians to Expand Long-Acting Reversible Contraceptive Access." (Duration 3:40) SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The provision of contraceptives is an essential component of preventive health care. Long-acting reversible contraceptive (LARC) methods include intrauterine devices (IUDs) and contraceptive implants. They are effective, reversible, and safe forms of contraception with very few contraindications (1). Intrauterine devices are also effective forms of emergency contraception (2). Many obstacles prevent patients from receiving these methods of contraception, including a critical lack of access in internal medicine (IM) primary care clinics (3).A subset of patients, including those at risk for adverse reproductive health outcomes, prefer to receive their contraceptive care in the primary care setting (4). One third of ...References1. Stoddard A, McNicholas C, Peipert JF. Efficacy and safety of long-acting reversible contraception. Drugs. 2011;71:969-980. [PMID: 21668037] doi:10.2165/11591290-000000000-00000 CrossrefMedlineGoogle Scholar2. Turok DK, Gero A, Simmons RG, et al. Levonorgestrel vs. copper intrauterine devices for emergency contraception. N Engl J Med. 2021;384:335-344. [PMID: 33503342] doi:10.1056/NEJMoa2022141 CrossrefMedlineGoogle Scholar3. Casas RS, Prifti CA, Bachorik AE, et al. Contraceptive procedures in internal medicine clinics and resident education: a qualitative study of implementation methods, barriers, and facilitators. J Gen Intern Med. 2021;36:3346-3352. [PMID: 33959883] doi:10.1007/s11606-021-06832-3 CrossrefMedlineGoogle Scholar4. Hall KS, Patton EW, Crissman HP, et al. A population-based study of US women's preferred versus usual sources of reproductive health care. Am J Obstet Gynecol. 2015;213:352. [PMID: 25935780] doi:10.1016/j.ajog.2015.04.025 CrossrefMedlineGoogle Scholar5. Agency for Healthcare Research and Quality. The number of practicing primary care physicians in the United States. 2018. Accessed at www.ahrq.gov/research/findings/factsheets/primary/pcwork1/index.html on 15 April 2023. Google Scholar6. Henrich JB, Schwarz EB, McClintock AH, et al. Position paper: SGIM sex- and gender-based women's health core competencies. J Gen Intern Med. 2023:1-5. [PMID: 37079185] doi:10.1007/s11606-023-08170-y CrossrefMedlineGoogle Scholar7. Rowlands S, Oloto E, Horwell DH. Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2016;7:19-32. [PMID: 29386934] doi:10.2147/OAJC.S85546 CrossrefMedlineGoogle Scholar8. De Gottardi A, Thévenot T, Spahr L, et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study. Clin Gastroenterol Hepatol. 2009;7:906-9. [PMID: 19447197] doi:10.1016/j.cgh.2009.05.004 CrossrefMedlineGoogle Scholar9. Innovating Education in Reproductive Health. LARC insertion & removal series. 2018. Accessed at www.innovating-education.org/course/larc-insertion-series on 1 June 2023. Google Scholar Author, Article, and Disclosure InformationAuthors: Jennifer L. Michener, MD; David A. Hirsh, MD; Pelin Batur, MD; Rachel S. Casas, MD, EdM; Vidya Gopinath, MD; Lydia E. Pace, MD, MPH; Christine Prifti, MD; Jennifer Rusiecki, MD; Eleanor Bimla Schwarz, MD, MS; Megha Shankar, MD; Mindy Sobota, MD, MS, MPhil; Deborah Gomez Kwolek, MDAffiliations: University of Colorado, Anschutz Medical Campus, Aurora, Colorado (J.L.M.)Harvard Medical School, Boston, Massachusetts, and Cambridge Health Alliance, Cambridge, Massachusetts (D.A.H.)Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (P.B.)Penn State College of Medicine, Hershey, Pennsylvania (R.S.C., M.S.)Warren Alpert Medical School of Brown University, Providence, Rhode Island (V.G., M.S.)Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts (L.E.P.)Boston University School of Medicine, Boston, Massachusetts (C.P.)The University of Chicago Pritzker School of Medicine, Chicago, Illinois (J.R.)San Francisco General Hospital, University of California, San Francisco, California (E.B.S.)Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (D.G.K.).Financial Support: None.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1034.Corresponding Author: Jennifer L. Michener, MD, 1635 Aurora Court, Aurora, CO 80045; e-mail, jennifer.michener@cuanshutz.edu.Author Contributions: Conception and design: J.L. Michener, D.A. Hirsh, P. Batur, E.B. Schwarz, M. Shankar, M. Sobota, D. Gomez Kwolek.Analysis and interpretation of the data: D.A. Hirsh, P. Batur, E.B. Schwarz, M. Shankar, M. Sobota.Drafting of the article: J.L. Michener, D.A. Hirsh, P. Batur, R.S. Casas, V. Gopinath, J. Rusiecki, E.B. Schwarz, M. Shankar, M. Sobota, D. Gomez Kwolek.Critical revision of the article for important intellectual content: J.L. Michener, D.A. Hirsh, P. Batur, L.E. Pace, C. Prifti, E.B. Schwarz, M. Shankar, M. Sobota, D. Gomez Kwolek.Final approval of the article: J.L. Michener, D.A. Hirsh, P. Batur, R.S. Casas, V. Gopinath, L.E. Pace, C. Prifti, J. Rusiecki, E.B. Schwarz, M. Shankar, M. Sobota, D. Gomez Kwolek.Administrative, technical, or logistic support: D.A. Hirsh, M. Sobota.Collection and assembly of data: P. Batur, L.E. Pace, E.B. Schwarz, M. Shankar, M. Sobota.This article was published at Annals.org on 1 August 2023.* Drs. Michener and Hirsh contributed equally to this work and are co–first authors. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Jennifer L. Michener, MD In this video, Jennifer L. Michener, MD, offers additional insight into the article, "Credentialing Internal Medicine Physicians to Expand Long-Acting Reversible Contraceptive Access." (Duration 3:40) FiguresReferencesRelatedDetails Metrics August 2023Volume 176, Issue 8Page: 1121-1123KeywordsContraceptivesFemale contraceptionIntrauterine devicesObstetrics and gynecologyPrimary care physicians ePublished: 1 August 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...